Ischemic Heart Disease Flashcards
What two factors put you at risk for developing coronary artery atherosclerosis?
Male Gender
Increased age
What are the 3 most dangerous chest pain differentials?
Aortic dissection
MI
PE
What is the gold standard for diagnosing ischemic heart disease?
12-Lead EKG (ST depression, T-wave inversion at the time of angina)
What is more sensitive than exercise stress test in diagnosing IHD?
Wall motion abnormalities on ultrasound
Losing ___% of body weight might reduce your risk of coronary disease by 50%
10%
What is the lifespan of a platelet?
7-14 days
After you discontinue P2Y12 inhibitors (Plavix/Prasugrel), how many of them can return to normal function?
80%
When do patients go on Statin therapy?
LDL > 160 (goal is < 70 mg/dL or 50% reduction)
Why do we put patients on ACE-I over BB?
ACE-I’s are cheaper
When do we do CABG over PCI?
Significant L. Main CAD
3-vessel CAD
DM with 2-3 vessel CAD
What drugs do we give patients with angina or who have IHD?
ASA
GPIIb/IIIa Inhibitors
P2Y12 Inhibitors
Statins
ACE-I
BB
Nitrates
Which substances contribute to thrombogenesis?
Collagen
ADP
Epinephrine
Serotonin
TXA2
GP IIb/IIIa receptors
What patient population have only mild to no pain at the time of an MI?
Elderly
Diabetes
What is required of a STEMI diagnosis?
Rise/Fall of cardiac biomarkers (troponin) AND **at least **one of the following
*symptoms of ischemia
* ECG changes
* Pathologic Q wave
* Imaging evidence of new loss of myocardium or wall motional abnormality
* ID of an intracoronary thormbus via angiogram
Drug therapy for someone with an MI?
FONAT
Fentanyl
Oxygen
Nitrates
Aspirin + P2Y12 (better outcomes)
Torodol (pain + mild anti-platelet)
What should be avoided in patients with STEMI?
Glucocorticoids and NSAIDS
Is thrombolytic therapy indicated for unstable angina?
NO, only give thromoblytics for STEMIS. Thrombolytics increase mortality in N-STEMI’s
What drug induces coronary plaque stabilization?
Statins
What drugs does almost everyone get for unstable angina?
Beta blockers
How long does it take fro the vessel to re-endothelialize after balloon angioplasty?
2-3 weeks
How long does it take for the vessel to re-endothelialize after Bare-metal stent placement
12 weeks
How long does it take for the vessel to re-endothelialize after Drug-eluting stent placement
1 year or longer
How long is someone on DAPT after an angioplasty w/o stenting?
Minimum 2 weeks
How long is someone on DAPT after a Bare-metal stenting?
Minimum 6 weeks
